Abstract
Fear of Positive Evaluation (FPE) was initially identified as an aspect of Social Anxiety Disorder (SAD). Subsequent studies have indicated FPE also plays a significant role in other psychiatric disorders. To date, however, FPE has not been examined in schizophrenia Therefore, the current study aimed to investigate FPE in schizophrenia. Inpatients with schizophrenia (n = 34) were compared with individuals with SAD (n = 30) and healthy controls (n = 30) in terms of FPE. Furthermore, the relationships between FPE and anhedonia, social anxiety, fear of negative evaluation were examined. The schizophrenia and SAD groups demonstrated significantly higher levels of FPE compared to healthy controls. Individuals with schizophrenia did not significantly differ in FPE from those with SAD. All factors including social anxiety, anhedonia, and fear of negative evaluation were significantly associated with FPE, with the association being stronger for social anxiety.Individuals with schizophrenia, similar to those with SAD, exhibit significantly high levels of FPE. This fear is associated with social anxiety, anhedonia, and fear of negative evaluation. Clinical interventions may benefit from targeting FPE when working with clients with schizophrenia. Further research in this area is needed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The data that support the findings of this study are openly available at https://figshare.com at https://doi.org/10.6084/m9.figshare.24551137
References
Bayani, A. A., Ranjbar, M., & Bayani, A. (2012). The relationship between social problem solving with depression and social phobia among university students. Journal Mazandaran University of Medical Sciences, 22(94), 92–99.
Berardelli, I., Serafini, G., Cortese, N., Fiaschè, F., O’Connor, R. C., & Pompili, M. (2020). The involvement of hypothalamus-pituitary-adrenal (HPA) Axis in suicide risk. Brain Sciences, 10(9). https://doi.org/10.3390/brainsci10090653.
Blanchard, J. J., Mueser, K. T., & Bellack, A. S. (1998). Anhedonia, positive and negative affect, and social functioning in schizophrenia. Schizophrenia Bulletin, 24(3), 413–424. https://doi.org/10.1093/oxfordjournals.schbul.a033336
Cho, H., Gonzalez, R., Lavaysse, L. M., Pence, S., Fulford, D., & Gard, D. E. (2017). Do people with schizophrenia experience more negative emotion and less positive emotion in their daily lives? A meta-analysis of experience sampling studies. Schizophrenia Research, 183, 49–55. https://doi.org/10.1016/j.schres.2016.11.016
Connor, K. M., Davidson, J. R. T., Erik Churchill, L., Sherwood, A., Foa, E., & Weisler, R. H. (2000). Psychometric properties of the social phobia inventory (SPIN). New self- rating scale. British Journal of Psychiatry, 176(APR), 379–386. https://doi.org/10.1192/bjp.176.4.379
Cosoff, S. J., & Hafner, R. J. (1998). The prevalence of comorbid anxiety in schizophrenia, schizoaffective disorder and bipolar disorder. Australian & New Zealand Journal of Psychiatry, 32(1), 67–72.
Costanza, A., Vasileios, C., Ambrosetti, J., Shah, S., Amerio, A., Aguglia, A., Serafini, G., Piguet, V., Luthy, C., Cedraschi, C., Bondolfi, G., & Berardelli, I. (2022). Demoralization in suicide: A systematic review. Journal of Psychosomatic Research, 157, 110788. https://doi.org/10.1016/j.jpsychores.2022.110788
Delavar, A. (2016). Research methods in psychology and educational sciences. Roshd Press.
Dickerson, S. S., Gruenewald, T. L., & Kemeny, M. E. (2004). When the social self is threatened: Shame, physiology, and health. Journal of Personality, 72(6), 1191–1216. https://doi.org/10.1111/j.1467-6494.2004.00295.x
Dowd, E. C., & Barch, D. M. (2010). Anhedonia and emotional experience in Schizophrenia: Neural and behavioral indicators. Biological Psychiatry, 67(10), 902–911. https://doi.org/10.1016/j.biopsych.2009.10.020
Fergus, T. A., Valentiner, D. P., McGrath, P. B., Stephenson, K., Gier, S., & Jencius, S. (2009). The fear of positive evaluation scale: Psychometric properties in a clinical sample. Journal of Anxiety Disorders, 23(8), 1177–1183. https://doi.org/10.1016/j.janxdis.2009.07.024
Ford, J. M., & Mathalon, H. D. (2011). Anticipating the future: Automatic prediction failures in schizophrenia. Bone, 23(1), 1–7. https://doi.org/10.1016/j.ijpsycho.2011.09.004.Anticipating.
Ghamari-Givi, H., & Molavi, P. (2010). Exploration of the factor structure of positive and negative syndrome scale in Schizophrenia Spectrum Disorders. Journal of Clinical Psychology, 2(2 (6)), 1–10.
Gilbert, P. (2001). Evolution and social and social hierarchies. Psychiatric Clinics of North America, 24(4), 273–751.
Gilbert, P. (2014). Evolutionary models: Practical and conceptual utility for the treatment and study of social anxiety disorder. The Wiley Blackwell handbook of social anxiety disorder (pp. 24–52). Wiley Blackwell. https://doi.org/10.1002/9781118653920.ch2
Gilboa-Schechtman, E., Shachar, I., & Sahar, Y. (2014). Positivity impairment as a broad-based feature of social anxiety. The Wiley Blackwell handbook of social anxiety disorder (pp. 409–432). Wiley Blackwell. https://doi.org/10.1002/9781118653920.ch19
Green, M. F., Horan, W. P., & Lee, J. (2019). Nonsocial and social cognition in schizophrenia: Current evidence and future directions. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 18(2), 146–161. https://doi.org/10.1002/wps.20624
James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, Z., Abera, S. F., Abil, O. Z., Abraha, H. N., Abu-Raddad, L. J., Abu-Rmeileh, N. M. E., Accrombessi, M. M. K., & Murray, C. J. L. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the global burden of Disease Study 2017. The Lancet, 392(10159), 1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7
Jordan, D. G., Winer, E. S., Salem, T., & Kilgore, J. (2018). Longitudinal evaluation of anhedonia as a mediator of fear of positive evaluation and other depressive symptoms. Cognition and Emotion, 32(7), 1437–1447. https://doi.org/10.1080/02699931.2017.1289895
Kashdan, T. B. (2007). Social anxiety spectrum and diminished positive experiences: Theoretical synthesis and meta-analysis. Clinical Psychology Review, 27(3), 348–365. https://doi.org/10.1016/j.cpr.2006.12.003
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261
Khazanov, G. K., Ruscio, A. M., & Forbes, C. N. (2020). The positive valence systems scale: Development and validation. Assessment, 27(5), 1045–1069. https://doi.org/10.1177/1073191119869836
Kingsep, P., Nathan, P., & Castle, D. (2003). Cognitive behavioural group treatment for social anxiety in schizophrenia. Schizophrenia Research, 63(1–2), 121–129.
Lambert, C., Da Silva, S., Ceniti, A. K., Rizvi, S. J., Foussias, G., & Kennedy, S. H. (2018). Anhedonia in depression and schizophrenia: A transdiagnostic challenge. CNS Neuroscience and Therapeutics, 24(7), 615–623. https://doi.org/10.1111/cns.12854
Meehl, P. E. (1990). Toward an integrated theory of schizotaxia, schizotypy, and schizophrenia. Journal of Personality Disorders, 4(1), 1–99.
Megreya, A. M. (2016). Face perception in schizophrenia: A specific deficit. Cognitive Neuropsychiatry, 21(1), 60–72. https://doi.org/10.1080/13546805.2015.1133407
Morris, S. E., & Cuthbert, B. N. (2012). Research domain criteria: Cognitive systems, neural circuits, and dimensions of behavior. Dialogues in Clinical Neuroscience, 14(1), 29. https://doi.org/10.31887/DCNS.2012.14.1/SMORRIS
Murante, T., & Cohen, C. I. (2017). Cognitive functioning in older adults with Schizophrenia. Focus (American Psychiatric Publishing), 15(1), 26–34. https://doi.org/10.1176/appi.focus.20160032
National Institute of Mental Health. (2018). RDoC Changes to the Matrix (CMAT) Workgroup Update: Proposed Positive Valence Domain Revisions, pp. 1–21. https://www.nimh.nih.gov/sites/default/files/documents/about/advisory-boards-and-groups/namhc/reports/cmat-sensorimotordomainreport-508.pdf
Pelizza, L., & Ferrari, A. (2009). Anhedonia in schizophrenia and major depression: State or trait? Annals of General Psychiatry, 8, 22. https://doi.org/10.1186/1744-859X-8-22
Pizzagalli, D. A. (2010). The Anhedonia Paradox in Schizophrenia: Insights from affective neuroscience. Biological Psychiatry, 67(10), 899–901. https://doi.org/10.1016/j.biopsych.2010.02.022
Reichenberger, J., & Blechert, J. (2018). Malaise with praise: A narrative review of 10 years of research on the concept of fear of positive evaluation in social anxiety. Depression and Anxiety, 35(12), 1228–1238. https://doi.org/10.1002/da.22808
Rezaei-Dogaheh, E., Mohammadkhani, P., & Dolatshahi, B. (2012). The comparison of group versus individual format of cognitive-behavior therapy on fear of positive evaluation. Archives of Rehabilitation, 13(1), 58–65.
Sohrabi, Z., & Sa’Dipour, E. (2020). The effectiveness of training self-encouragement on cognitive slippage and fear of negative evaluation. Developmental Pscychology, 16(64), 401–410.
Treadway, M. T., Buckholtz, J. W., Schwartzman, A. N., Lambert, W. E., & Zald, D. H. (2009). Worth the EEfRT? The effort expenditure for rewards task as an objective measure of motivation and anhedonia. PLoS One1, 4(8), 1–9. https://doi.org/10.1371/journal.pone.0006598
Treadway, M. T., Peterman, J. S., Zald, D. H., & Park, S. (2015). Impaired effort allocation in patients with schizophrenia. Schizophrenia Research, 161(2–3), 382–385. https://doi.org/10.1016/j.schres.2014.11.024
van der Gaag, M., Schütz, C., Napel, T., Landa, A., Delespaul, Y., Bak, P., Tschacher, M., & de Hert, M. (2013). Development of the Davos assessment of cognitive biases scale (DACOBS). Schizophrenia Research, 144(1–3), 63–71. https://doi.org/10.1016/j.schres.2012.12.010
van Os, J., Kenis, G., & Rutten, B. P. F. (2010). The environment and schizophrenia. Nature, 468(7321), 203–212. https://doi.org/10.1038/nature09563
Vidailhet, P. (2013). [First-episode psychosis, cognitive difficulties and remediation]. L’Encephale, 39(Suppl 2), 83–92. https://doi.org/10.1016/S0013-7006(13)70101-5
Wallace, S. T., & Alden, L. E. (1995). Social anxiety and standard setting following social success or failure. Cognitive Therapy and Research, 19(6), 613–631. https://doi.org/10.1007/BF02227857
Watson, D., & Friend, R. (1969). Measurement of social-evaluative anxiety. Journal of Consulting and Clinical Psychology, 33(4), 448–457. https://doi.org/10.1037/h0027806
Weeks, J. W. (2015). Replication and extension of a hierarchical model of social anxiety and depression: Fear of positive evaluation as a key unique factor in social anxiety. Cognitive Behaviour Therapy, 44(2), 103–116. https://doi.org/10.1080/16506073.2014.990050
Weeks, J. W., & Howell, A. N. (2012). The Bivalent fear of evaluation model of social anxiety: Further integrating findings on fears of positive and negative evaluation. Cognitive Behaviour Therapy, 41(2), 83–95. https://doi.org/10.1080/16506073.2012.661452
Weeks, J. W., Heimberg, R. G., & Rodebaugh, T. L. (2008a). The fear of positive evaluation scale: Assessing a proposed cognitive component of social anxiety. Journal of Anxiety Disorders, 22(1), 44–55. https://doi.org/10.1016/j.janxdis.2007.08.002
Weeks, J. W., Heimberg, R. G., Rodebaugh, T. L., & Norton, P. J. (2008b). Exploring the relationship between fear of positive evaluation and social anxiety. Journal of Anxiety Disorders, 22(3), 386–400. https://doi.org/10.1016/j.janxdis.2007.04.009
Weeks, J. W., Jakatdar, T. A., & Heimberg, R. G. (2010). Comparing and contrasting fears of positive and negative evaluation as facets of social anxiety. Journal of Social and Clinical Psychology, 29, 68–94. https://doi.org/10.1521/jscp.2010.29.1.68
Winer, E. S., Bryant, J., Bartoszek, G., Rojas, E., Nadorff, M. R., & Kilgore, J. (2017). Mapping the relationship between anxiety, anhedonia, and depression. Journal of Affective Disorders, 221, 289–296. https://doi.org/10.1016/j.jad.2017.06.006
Acknowledgements
All authors thank the authorities of Psychiatry Centers in Shiraz city and all subjects for their sincere cooperation in performing the study.
Funding
This research was funded by the Shiraz University of Medical Sciences (27679).
Author information
Authors and Affiliations
Contributions
Zeraatpisheh, Z., conceived the original idea. Zeraatpisheh, Z., and Daneshvar, S., designed and directed the project, and developed the theoretical framework; Tollabzadeh, Z., contributed to sample preparation and carried out the implementation; Zeraatpisheh, Z., and Daneshvar, S., performed the analytic calculations; Zeraatpisheh, Z., and Daneshvar, S., wrote the article; Jobson, L., conceived the study and were in charge of the overall direction and planning. All authors provided critical feedback and helped shape the research, analysis, and manuscript.
Corresponding author
Ethics declarations
Ethics Code
The Institutional Review Board of the Shiraz University of Medical Sciences approved the experimental protocol (ID: IR.SUMS.REC.1402.033).
Conflicting interests
The author(s) declared no conflicts of interest concerning the research, authorship, and/or publication of this article.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Zeraatpisheh, Z., Daneshvar, S., Tollabzadeh, Z. et al. Investigating fear of positive evaluation in schizophrenia. Curr Psychol (2024). https://doi.org/10.1007/s12144-024-06002-8
Accepted:
Published:
DOI: https://doi.org/10.1007/s12144-024-06002-8